Mental Health Patients Sent Miles Due to Bed Shortage

Hundreds of mental health patients in England are sent to hospitals miles from home each month because of local bed shortages, more than a year after the NHS aimed to end the practice. NHS data shows that 630 patients were in inappropriate out of area placements (OAPs) at the end of August 2022.

Experts say such placements, which the NHS said would end by March 2021, are traumatic for patients and costly.

The government said it was investing an extra £2.3bn in mental health services.

An inappropriate OAP is when someone is sent to a hospital in a different area because no beds are free locally. Of the 630 patients in inappropriate OAPs in August 2022, more than half were sent away that month.

Paul Spencer, the charity Mind’s head of health, policy & campaigns, describes OAPs as traumatic, isolating and costly to the NHS. He says that “people are cut off from their support networks right at the very moment they need them most”.

More than half of patients are sent more than 60 miles (100km) from home.

Dr Adrian James, president of the Royal College of Psychiatrists, says “statistically, if you’re sent away from your local area, you stay in hospital longer. For some areas it looks like there aren’t enough beds and for some areas, it is that there aren’t alternatives to admission. Focusing on care in the community is really important,” says Dr James.

Almost £10m was spent on inappropriate OAPs in August, with 94% of placement days spent with private organisations. Private beds are often more expensive.

The NHS had planned to eliminate inappropriate OAPs in adult acute inpatient care by 2020-21. Since that deadline, 5,800 patients have been sent on inappropriate OAPs. This has cost the NHS more than £165m.

“It’s incredibly disheartening to see progress stall on reversing the number of inappropriate OAPs”, says Mr Spencer. “We know that it is possible to stop OAPs and some trusts are doing much better than others. Over the coming year we need a sharper focus in those areas where people are being repeatedly let down. We need the prime minister to urgently recommit to delivering a cross-government mental health plan.”

An NHS spokesperson said: “Mental health services are committed to ending inappropriate OAPs as quickly and as safely as possible and the number of new patients sent out of area has halved over the last three years.

“While the pandemic has led to a significant increase in service pressures through a combination of a high number of bed closures, staff absences, and higher levels of mental health need – the NHS has treated tens of thousands more people in the community since the publication of the NHS Long Term Plan and will continue to work with social care colleagues to reduce rising length of stay in mental health settings.”

Across England, patients spent a total of 191,515 inappropriate OAPs days in the year ending this August, down 19% from the year before, but 25 trusts saw an increase in the number of days patients spent in OAPs, with 12 trusts recording their highest figure of OAP days yet.